Doctors should say no to free lunches

By Jim Giles

Want to influence how doctors treat their patients? Just don a suit and bring a bag of doughnuts. Pharmaceutical sales representatives have for years been using such low-value gifts – as well as more blatant means, such as free trips to conferences – to persuade doctors to prescribe their particular brand of drug, and there is ample evidence showing it works. Unlikely as it sounds, doughnuts, pens, notepads and the like are effective weapons in the fight for market share among pharmaceutical giants.

That fight, it seems, is becoming ever fiercer, with the number of drug reps in the US more than doubling in the past 10 years. Several recent studies have highlighted the extent of such tricks and their influence on medical practice, and there is a growing clamour for something to be done.

The gifts are handed out by reps, also known as detailers, who tour the offices of doctors in the US and Europe. They might also bring samples of new drugs to give away, and perhaps an offer of lunch should the doctor want to know more about the products the rep has come to discuss. It sounds like an innocent enough process; certainly one that a doctor could handle without being unduly influenced.

Not so. Gifts, even small ones, buy influence. They can help obscure the shortcomings of a medication or distract physicians from cheaper alternatives. In extreme cases, reps have used gifts as part of broader campaigns to persuade doctors to prescribe a drug to patients with entirely different conditions from those it is licensed to treat.

The sophistication of the pharmaceutical marketing machine was revealed ...

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